Diabetes raises mortality after coronary bypass

People with type 2 diabetes have a higher likelihood of dying shortly after undergoing coronary artery bypass graft surgery, even when a number of risk factors are taken into account, new study results indicate.

For people with diabetes and heart disease affecting several coronary arteries, bypass surgery is considered preferable to angioplasty, Dr. Scott E. Woods of the Bethesda Family Residency Program in Cincinnati, Ohio, and colleagues point out in the medical journal Chest.

However, they say, this approach "is not without risk."

To investigate further, the team followed more than 6700 patients who underwent coronary artery bypass grafting, about a third of whom had type 2 diabetes.

In the month after surgery, the mortality rate as 3.9 percent among diabetic patients versus 2.6 percent for those without diabetes.

After adjustment for other risk factors, the diabetic group still had a 67 percent higher mortality risk.

Apart from the significantly increased risk of dying, the people with diabetes also had longer hospital stays, experienced more kidney and wound complications, and had more periods when their heart's pumping strength dropped.

Woods' team suggests that the effects of high blood sugar and increased fatty acids in people with diabetes could influence outcomes after bypass surgery.

SOURCE: Chest, December 2004.